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Barell Matrix— moving to ICD-10. Lois A. Fingerhut May 2004. Barell Matrix . Conceived for injury morbidity Codes based on ICD-9 CM Not useful for those not using ICD-9 CM. Barell Matrix . Why update to ICD-10? US Cost of Injury Study Multiple cause of injury death analysis

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barell matrix moving to icd 10

Barell Matrix—moving to ICD-10

Lois A. Fingerhut

May 2004

barell matrix
Barell Matrix
  • Conceived for injury morbidity
    • Codes based on ICD-9 CM
    • Not useful for those not using ICD-9 CM
barell matrix3
Barell Matrix
  • Why update to ICD-10?
    • US Cost of Injury Study
    • Multiple cause of injury death analysis
    • Used in both mortality and morbidity
      • Adaptable to different versions of clinical modifications
difficulties
Difficulties…
  • ICD-9 CM is not meant to crosswalk to ICD-10
  • ICD-9 and ICD-10 injury chapters differ!
    • ICD-9 main axis is nature of injury
    • ICD-10 main axis is body region of injury
      • Hence translation is not straightforward
  • Comparability study in US not completed for injury diagnosis codes
more difficulties
More difficulties…
  • Traumatic brain injury codes are particularly problematic
  • Morbidity codes are more detailed than mortality codes because more information is on medical record than on death certificate
nonetheless
Nonetheless…
  • December 2002 I received an email from Richard Hockey in Australia
    • NDS-IS Nature/Body part matrix from ICD9-AM to ICD10-AM
    • Categories are those used in NDS-IS V2.1 developed by James Harrison
  • By July 2003 I produced a first draft based on ICD-10 S&T codes
    • Sent to Limor, Ellen, Lee, James & Richard for comment
    • Needs more comment!!
comments
Comments
  • ICD-10 is not “designed” for a single code
    • Perhaps pairs of codes should be used
  • S09.9 – Australian example:
    • ICD-9 854 was used in ED for any suspected intracranial head injury and its nearest equivalent in 10 is S09.9 unspecified injury of head
progress to date
Progress to date
  • Sept 2003: Ted Miller (US Cost of Injury expert) programmed SAS codes for draft matrix
  • US NHTSA wants a matrix (have been emailing me for more than a year!)
  • What to code: Entity vs Record axis- another decision
  • Any vs total mention (from US multiple cause file)
  • CDC-NCIPC wants TBI comparable codes
  • May 2004- presentation to NCIPC on TBI comparability
what next
What next?
  • Draft matrix needs more international review and comment
  • Mortality
    • 1st listed code?
    • Main injury?
    • Multiple injuries?
  • Morbidity
    • What clinical versions are being used?
    • Are they compatible with ICD-10?
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